Spotlight On: Vaping

Electronic cigarettes (e-cigarettes), commonly referred to as ‘vapes’, first came on the U.S market in 2007, but data on their mental and physical health effects is just starting to take shape.

Vaping uses a battery-powered device to heat, aerate and inhale a liquid (e-juice), which usually contains flavoring and nicotine. Initially promoted as a way for adults to quit smoking cigarettes, e-cigarettes rapidly gained popularity with minors – most of whom had never before smoked tobacco.

From Juuls to Puff Bars, vapes’ novelty, appealing flavors, high-tech design, and colorful packaging became an international sensation. Before long, vaporized e-juice was being inhaled not just by adults, but by millions of adolescents, at a time when teenage tobacco use in the U.S. had been at an all-time low.

Because electronic cigarettes are still a relatively new product, the long-term effects of vaping are still not entirely understood. However, concerning data is starting to emerge.

Let’s examine 10 popular vaping myths, in light of what we know.

Myth #1: “E-cigarettes produce a harmless cloud of water vapor.”

Not true. The ‘vapor’ that carries e-juice into the lungs is neither harmless nor simply aerosolized water. It contains heated propellants, solvents, ultrafine particles, toxic heavy metals, dyes, fragrances, pesticides, and volatile chemicals – some carcinogenic (cancer-causing). Vaping also produces acetaldehyde, implicated in lung disease, and diacetyl, known to scar the lungs. With nearly ten thousand vaping products flooding the market, the FDA is unable to test them all. Each diverse flavor mix can carry its own toxicities, but what they all have in common is usually the inclusion of nicotine.

Myth #2: “Vaping isn’t addictive.”

False. The truth is, 99% of vaping products contain nicotine, a chemical as addictive as many Schedule 1 or 2 controlled substances. Within 10-20 seconds of a puff off a vape device, nicotine reaches the brain, causing a surge of dopamine which shapes brain function and behavior. Youth under 25 are especially vulnerable to nicotine dependence, as their brains are still developing. Ways to gauge if one might be becoming dependent on nicotine include experiencing an urge to vape upon waking, or acute frustration when one’s vape device goes missing.

Myth #3: “Vaping is not as bad for you as smoking.”

Too soon to tell. Vaping continues to be assumed to be less harmful than tobacco smoking, but is by no means ‘safe,’ according to the World Health Organization. There simply hasn’t been enough time to gather medical data on the long-term effects. Recent studies on mice exposed to e-cigarette vapor have resulted in alarming rates of lung cancer (22.5%) and pre-cancerous changes to bladder tissue (57.5%).  Doctors also see relationships between vaping and respiratory disease, including a 2-3 times increased risk for COPD (Chronic Obstructive Pulmonary Disease), and higher rates of asthma and lung infections.

Myth #4: “Vaping helps you quit smoking.”

Not proven. Many people switch from traditional cigarettes to e-cigarettes to help them quit smoking. But because a typical vape device can deliver as many ‘puffs’ – and as much nicotine – as 2 or more packs of cigarettes, about 1/3 of adult smokers who take up vaping continue to smoke traditional cigarettes when e-cigarettes are unavailable. They become ‘dual’ smokers, with dual risks. Even more concerning, The American Academy of Pediatrics reports that youth ages 12-17 who vape are 4x more likely to progress to smoking cigarettes, even when they had no intention to do so.

Myth #5: “Vaping relieves my stress and anxiety.”

It may feel that way for a moment. But in the long-term, the opposite is true: the more one vapes, the more unsettled, irritable, and anxious one can feel. Those feelings are initially relieved by puffing on a vape device, but it’s all a cycle created by nicotine dependence. The Truth Initiative affirms that in one study, 90% of those surveyed said they felt less stressed, anxious, or depressed after they quit vaping.

Myth #6: “Vaping can’t affect your mental health.”

Vaping does affect mental health. Research confirms that mental well-being declines with frequent vape use. Nicotine causes long-term changes to brain function in areas associated with mood, impulse control, attention, energy levels, and learning, according to the American Psychiatric Association. Negative feelings of depression are amplified, and the natural brain chemicals that help us feel calm and happy –serotonin and dopamine – become depleted, dropping to below-baseline levels. Frequent vaping is associated with sleep disruption, withdrawal from former activities, and lower academic achievement. The action of habitually turning to a nicotine delivery device in response to stress may also delay adolescents’ development of healthier coping skills.

Myth #7: “Most vaping is done by mature adults.”

Sadly, not true. More people in their late teens to early 20’s vape than any other age group. Youth may vape for various reasons, including easy access, affordability, because peers or family members do it, for a nicotine ‘buzz’, or because they think it’s not harmful. Teens are lured by an endless variety of kid-friendly vape flavors, reminiscent of candy, breakfast cereals and desserts. Minors may also be exposed to ‘vaping influencers’, fashionable spokesmodels on social media platforms who demonstrate new products and visual tricks that can be performed with clouds of vapor. That’s why educating kids about the harms of vaping is so essential.

Myth #8: “Kids can’t buy vapes.”

Kids do buy vapes. Although more than half of youth obtain vape products from friends or family, the National Institutes of Health reports that in 2021, 1/3 of youth bought them from retail sources (vape and tobacco shops, or gas stations), whose employees may be lax or non-compliant with age verification. Kids can also obtain vaping products online, through retail home-delivery, from person-to-person ‘dealers’ readily found on social media platforms, or from other students. In Oregon, it is illegal to sell vaping products to youth under 21, but kids get ahold of them, nevertheless. And Douglas County students who participated in the Oregon Student Health Survey (2022) reported that they vape nicotine at almost twice the rate of 8th and 11th graders statewide.

Myth #9: “The fruity flavors that lure kids to vape have been banned.”

Unfortunately, not. Although the FDA banned fruit-flavored vaping pods and cartridges in 2020, there were loopholes. Regulation did not prohibit fruit-flavored tanks of e-juice or disposable vapes, which immediately soared in popularity. Inhalant delivery systems are not supposed to be packaged in ways attractive to persons under 18, according to Oregon law, but many still are. Sales of flavored nicotine products will be prohibited in Multnomah County starting in 2024, but as of November 2023, Douglas County has not yet initiated a ban on any of the thousands of flavors of vapes that appeal to kids.   

Myth #10: “Most teenagers vape, anyways.”  

Happily, not true!  The vast majority of middle and high school students do not vape, and that’s important for pre-teens to know. It’s also crucial that they understand the risks,  because – chances are –  they’ll be offered a ‘hit’ off a vape device someday. Teen smoking had dropped from 23% in the year 2000 to only 2% in 2021 – a hard-won, historic low. But in the past few years, the use of e-cigarettes has drastically raised the rate of nicotine dependence among youth. The 2022 National Youth Tobacco Survey reports that an average of 14% of high school students and 3% of middle school students now regularly use e-cigarettes. 

Myth #11: “I’d know if my child was vaping.”

Not always. That’s part of the appeal to teens. Vape devices are small, concealable, and can be packaged to look like things they are not: highlighters, pens, lipstick tubes, or USB flash drives. Kids may be exhaling into their sweatshirts, blankets, or sleeves. Unlike cigarette smoke, the tell-tale smell of tobacco doesn’t linger on their clothing or breath. To help identify if your child is vaping, look out for behavior changes, such as increased anxiety, irritability, or difficulty concentrating. Physical side effects may include trouble breathing, coughing or wheezing, and headaches.

Myth #12: “Once you start vaping, it’s impossible to quit.”

Definitely not. Quitting vaping (or smoking), while difficult, is always possible. It takes some initial ‘urge surfing’ (a self-regulation technique of recognizing a craving and ‘riding it out,’ without acting on it), but nicotine withdrawal symptoms will fade over time. There are many supportive resources to help. Youth and young adults can text DitchVape to 88709 to get tips sent to them on how to successfully cope with quitting (a free, anonymous service from the Truth Initiative). Parents can text QUIT to (847) 278-9715 to sign up for text messages to help them support a child trying to quit.  Adapt can help. At Adapt Integrated Health Care, we understand the challenges of quitting as well as the improved quality of life that unfolds for those who do. Adapt offers personalized treatment plans for anyone interested and willing to make a change. Call (541) 492-0222 if you’d like to set up an appointment.